ENDOCARDIAL FIBROSIS IN NEUROENDOCRINE TU MORS OF THE GASTROENTEROPANCREATIC SYSTEM

Clinical characteristics, echocardiographic and Doppler echocardiograp hic findings, as well as serum levels of chromogranin A were recorded on 62 patients (27 women, 35 men; mean age 55 [11-83] years) with hist ologically confirmed tumours of the gastroenteropancreatic (GEP) syste m. Changes in the right heart were found in 14 patients (22%), club-li ke thickening of tricuspid leaflets in 13, tricuspid regurgitation in 14, stenosis in 2 and right atrial or right ventricular dilatation in 11 and 5, respectively. There was no difference between the patients w ith or without right-heart changes in regard to age, presence of carci noid syndrome, duration of symptoms, primary tumour site, pattern of m etastases, treatment or chromogranin A level. Two patients with nonfun ctioning tumours had right-heart changes. - While clinical and biochem ical parameters did not identify patients with right-heart changes, ec hocardiography demonstrated all haemodynamically significant endocardi al changes. Even patients with nonfunctioning GEP tumours should be re gularly monitored by echocardiography.